A Therapeutic Musician's Duty of Care

The duty of care for certified therapeutic musicians is a comprehensive professional and ethical responsibility that ensures the well-being, comfort, and safety of patients, families, and staff in healthcare and caregiving environments. This duty encompasses providing therapeutic music with intention, sensitivity, and professionalism, adhering to established guidelines for ethical practice, and collaborating effectively with healthcare teams.

1. Scope of Practice

Certified therapeutic musicians provide therapeutic music—live, intentional music designed to create a healing environment and support the physical, emotional, and spiritual well-being of patients.

• Role Definition: Their role is distinct from that of a music therapist. Therapeutic musicians do not use clinical interventions, make diagnoses, or engage in psychotherapeutic techniques unless certified in those fields.

• Boundaries: They focus on providing music as a supportive, non-invasive complement to medical care rather than a replacement for medical treatment.

2. Patient-Centered Care

Therapeutic musicians must prioritize the unique needs and preferences of each patient.

• Respect for Individuality: Tailor the music to align with the patient’s preferences, cultural and spiritual background, and emotional state. When possible, collaborate with the patient or their family to select appropriate music.

• Non-Intrusiveness: Ensure the music enhances the environment without causing overstimulation or discomfort. This includes adjusting volume, tempo, and repertoire as needed.

3. Safety and Hygiene

Safety and hygiene are critical in maintaining a healthy environment for both patients and musicians.

Instrument Hygiene:

• Regularly clean and sanitize the harp and other equipment to prevent contamination.

• Position the harp to avoid interference with medical devices, cords, or staff activities.

Harpist Hygiene:

• Wash hands or use hand sanitizer before and after each session.

• Adhere to facility-specific infection control protocols, including wearing personal protective equipment (PPE) when necessary.

• Avoid playing for patients if the harpist is unwell or potentially contagious.

Physical Safety:

• Ensure the harp and other equipment are stable and do not pose a tripping or collision hazard.

• Be mindful of spatial constraints and maintain an appropriate distance from the patient and medical devices.

4. Sensitivity to Medical and Emotional Contexts

Therapeutic musicians must remain aware of the medical and emotional states of patients and adapt their approach accordingly.

• Observation and Adaptation: Monitor patients for signs of comfort or distress and adjust the music accordingly. If the music appears to cause discomfort, stop playing or modify the style.

• Emotional Awareness: Recognize that patients may be experiencing anxiety, pain, grief, or fear. Provide therapeutic music that supports their emotional needs, such as calming, uplifting, or reflective tones.

• End-of-Life Care: In hospice or palliative care settings, music can provide comfort and spiritual support. Be sensitive to the needs of both the patient and their loved ones during these moments.

5. Professionalism and Confidentiality

Professional conduct and adherence to ethical standards are essential in building trust with patients, families, and healthcare staff.

• Confidentiality: Maintain patient privacy and comply with relevant laws and regulations, such as HIPAA in the United States.

• Appearance and Demeanor: Dress appropriately and project a calm, respectful presence. Avoid behaviors that might detract from the therapeutic environment.

• Communication: Use clear and empathetic communication when interacting with patients, families, and staff. Explain your role if necessary, and address any questions or concerns with respect.

6. Collaboration with Healthcare Teams

Therapeutic musicians are part of a larger caregiving team and must work in harmony with healthcare professionals.

• Coordination: Align your timing and approach with the care team’s activities. For example, avoid playing during medical procedures unless invited by staff.

• Feedback: Be open to input from healthcare providers regarding the appropriateness of your music for specific patients or situations.

• Flexibility: Adapt to the dynamic nature of healthcare settings, such as unexpected emergencies or changes in patient conditions.

7. Cultural and Spiritual Sensitivity

Music often holds deep cultural and spiritual significance, and therapeutic musicians must respect these aspects.

• Cultural Awareness: Understand and honor the cultural context of the patient, including music traditions, preferences, and sensitivities.

• Spiritual Support: In situations where music is used for spiritual comfort, such as end-of-life care, be responsive to requests for specific hymns, chants, or other sacred music.

8. Emotional Resilience and Self-Care

Working in caregiving environments can be emotionally challenging. Therapeutic musicians must maintain their own well-being to provide effective care.

• Emotional Awareness: Recognize the emotional toll of working in settings involving illness, trauma, or end-of-life care. Seek supervision, peer support, or personal counseling as needed.

• Self-Care Practices: Engage in activities that replenish your energy and resilience, such as mindfulness, creative expression, or rest.

• Professional Boundaries: Avoid over-identifying with patients or becoming emotionally over-involved, which can lead to burnout.

9. Ongoing Learning and Professional Growth

Therapeutic musicians have a responsibility to maintain and enhance their skills and knowledge.

• Continuing Education: Participate in workshops, training programs, or certification renewals to stay current with best practices in therapeutic music.

• Repertoire Expansion: Develop a diverse repertoire to accommodate varying patient needs and cultural preferences.

• Feedback and Reflection: Actively seek feedback from patients, families, and staff, and reflect on your experiences to continuously improve your practice.

10. Legal and Ethical Considerations

• Liability Coverage: Maintain professional liability insurance to protect against potential risks.

• Compliance: Follow all facility policies and legal regulations regarding your practice as a certified therapeutic musician.

• Ethical Practice: Uphold the highest standards of integrity, respect, and compassion in all interactions.

By adhering to these principles, certified therapeutic musicians fulfill their duty of care, providing meaningful and impactful support to patients while fostering a healing and compassionate environment. This holistic approach enhances the quality of care and underscores the profound role of therapeutic music in health and well-being.